September Medical Journal Review
Prof. Richard F. Lockey MD, WAO Web Editor-in-Chief, reviewed premiere September medical journal articles for practicing allergists. Read his top picks below and click the journal link to read article abstracts.
1. AMONG INNER-CITY CHILDREN WITH ATOPIC ASTHMA, AN INDIVIDUALIZED, HOME-BASED, COMPREHENSIVE ENVIRONMENTAL INTERVENTION DECREASES EXPOSURE TO INDOOOR ALLERGENS (COCKROACH AND DUST MITES) RESULTING IN REDUCED ASTHMA ASSOCIATED MORBIDITY. Morgan WJ et al, N Engl J Med 2004, 351:1068.
2. WORLD ALLERGY ORGANIZATION GUIDELINES FOR PREVENTION OF ALLERGY AND ASTHMA, CONDENSED VERSION. Editor's comment: MUST READING. Johansson SGO, Haahtela T (eds) et al. Int Arch Allergy Immunol 2004; 135:83.
3. OMALIZUMAB (ANTI-IGE) IN ALLERGIC SUBJECTS CAUSES RAPID DECLINE IN CIRCULATING FREE IGE, SURFACE BOUND IGE, AND IGE RECEPTORS IN BLOOD BASOPHILS. This study demonstrates that such infusions over six months also reduce skin mast cell receptor numbers and function and reduce the size of allergen induced acute wheals, perhaps even late-phase responses. Beck LA et al, J Allergy Clin Immunol 2004;114:527.
4a. ANTI-IGE (OMALIZUMAB) REDUCES SERUM IGE AND IGE+ CELLS IN AIRWAY MUCOSA; SPUTUM EOSINOPHILIA; TISSUE EOSINOPHILIA; CELLS POSITIVE FOR THE HIGH-AFFINITY FC RECEPTOR FOR IGE; CD3+, CD4+, AND CD8+ T LYMPHOCYTES; B LYMPHOCYTES; AND CELLS STAINING FOR INTERLEUKIN-4. It did not improve airway hyperresponsiveness to methacholine, suggesting that IgE or eosinophils may not be causally linked to airway hyperresponsiveness to methacholine. Djukanovic R et al, Am J Respir Crit Care Med 2004;170:583.
4b. EOSINOPHILS ARE THE DOMINANT INFLAMMATORY CELL PRESENT IN THE LUNGS OF ASTHMATICS. In a transgenic line of mice specifically devoid of eosinophils, but otherwise hematologically intact, allergen challenged demonstrate eosinophils are required for pulmonary mucus accumulation and airway hyperresponsiveness. Lee JJ et al, Science 2004; 305:1773.
4c. IN ANOTHER STUDY IN SCIENCE, ABLATION OF THE EOSINOPHIL LINEAGE IN MICE DID NOT INHIBIT AIRWAY HYPERRESPONSIVENESS AND MUCUS SECRETION. However, eosinophilic ablation did result in significant protection against peribronchiolar collagen deposition and increases in airway smooth muscle. Editor's comment: The saga of the eosinophil continues. Humbles AA et al, Science 2004; 305:1776.
5a. LEUKOTRIENE RECEPTOR ANTAGONIST NOT EFFECTIVE THERAPY FOR CHRONIC IDIOPATHIC URTICARIA IN A PLACEBO-CONTROLLED, DOUBLE-BLIND EXAMINATION OF DESLORATADINE, MONTELUKAST, BOTH, OR NEITHER IN 160 PATIENTS WITH MODERATE CHRONIC IDIOPATHIC URTICARIA. Desloratadine alone is effective. Editor's comment: Montelukast NOT HELPFUL for urticaria. Di Lorenzo G et al, J Allergy Clin Immunol 2004; 114:619.
5b. A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY OF CHRONIC URTICARIA COMPARED ORAL DESLORATADINE PLUS PLACEBO TO DESLORATADINE PLUS MONTELUKAST TO ORAL PLACEBO ALONE. BOTH ORAL DESLORATADINE AND THE COMBINATION OF DESLORATADINE AND MONTELUKAST WERE EFFECTIVE TREATMENT MODALITIES. However, the combination was shown to improve symptoms and quality of life significantly more than the antihistamine alone. Editor's comment: Montelukast HELPFUL for urticaria. Nettis E et al, Clin Exp Allergy 2004; 34:1401.
6. Epidemiologic study. AIR POLLUTION ADVERSELY AFFECTS LUNG DEVELOPMENT IN CHILREN FROM AGE 10 TO 18. It leads to clinically significant deficits in FEV1 as children reach adulthood. Gauderman WJ et al, N Engl J Med 2004, 351:1057.
7. IN A CROSS-SECTIONAL DESIGN STUDY, AIRFLOW LIMITATION, AIRWAY INFLAMMATION, AND FEATURES COMMONLY ASSOCIATED WITH ASTHMA ARE SEPARATELY AND LARGELY INDEPENDENT FACTORS IN THE PATHOPHYSIOLOGY OF COPD. Lapperre TS et al, Am J Respir Crit Care Med 2004;170:499.
8. SIGNIFICANT NUMBERS OF INFLUENZA-ASSOCIATED HOSPITALIZATIONS IN THE UNITED STATES OCCUR AMONG THE ELDERLY, HAVING INCREASED OVER THE PAST TWO DECADES SECONDARY TO THE AGING POPULATION. Children younger than 5 years have similar rates of influenza-associated hospitalizations to those individuals aged 50 through 64. Influenza prevention is necessary for both the younger and older populations. Thompson WW et al, JAMA 2004;292:1333.
9. HUMAN MILK OLIGOSACCHARIDES ARE ASSOCIATED WITH PROTECTION AGAINST DIARRHEA IN BREAST-FED INFANTS. Levels of 2-linked fucosyloligosaccharide decrease the incidence of Campylobacter, caliciviruses, and diarrhea of all causes in breast-fed infants. Morrow AL et al, J Pediatr 2004;145:297.
